Prophylactic corticosteroid use prevents engraftment syndrome in patients after autologous stem cell transplantation.

Betticher, Christophe; Bacher, Ulrike; Legros, Myriam; Zimmerli, Stefan; Banz, Yara; Mansouri Taleghani, Behrouz; Pabst, Thomas (2020). Prophylactic corticosteroid use prevents engraftment syndrome in patients after autologous stem cell transplantation. (In Press). Hematological oncology Wiley 10.1002/hon.2813

[img] Text
hon.2813 (1).pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (435kB) | Request a copy

Engraftment syndrome (ES) following autologous stem cell transplantation (ASCT) at the time of neutrophil recovery may comprise fever, rash, pulmonary edema, or diarrhea. Usually, ES is easily manageable using corticosteroids but may prolong hospitalization. In two consecutive cohorts of subsequent patients with myeloma, lymphomas, and testicular/germ cell cancer, we assessed the benefit of corticosteroid use to prevent incidence and severity of ES following ASCT. Whereas Cohort A (82 patients) received no prophylactic corticosteroids, corticosteroids (4 mg dexamethasone oral daily) were started in Cohort B (60 patients) at day +9 until day +13 following ASCT. Steroid prophylaxis significantly reduced the incidence of ES (6/60; 10% vs. 33/82; 40%; p < 0.001). Hospitalization duration was longer in patients with ES than in patients without ES within both cohorts (in Cohort A: p = 0.007; and B: p = 0.011), but did not differ significantly between cohorts A and B. Finally, in Cohort A, there was a trend to an inferior 2-year overall survival rate in patients without ES compared to patients with ES (p = 0.067), but definite conclusions are not yet allowed. Our results suggest that corticosteroid prophylaxis from days +9 to +13 following ASCT significantly reduces the risk of ES and shortens hospitalization duration.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory
04 Faculty of Medicine > Service Sector > Institute of Pathology
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Bacher, Vera Ulrike; Legros, Myriam; Zimmerli, Stefan; Banz Wälti, Yara; Mansouri Taleghani, Behrouz and Pabst Müller, Thomas Niklaus

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology

ISSN:

1099-1069

Publisher:

Wiley

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

02 Nov 2020 16:30

Last Modified:

02 Nov 2020 16:30

Publisher DOI:

10.1002/hon.2813

PubMed ID:

32979278

Uncontrolled Keywords:

autologous stem cell transplantation corticosteroid prophylaxis engraftment syndrome lymphoma myeloma

BORIS DOI:

10.7892/boris.147172

URI:

https://boris.unibe.ch/id/eprint/147172

Actions (login required)

Edit item Edit item
Provide Feedback